A clinical review of 180 cases of biliary tract diseases, which were operated at the Dept. of Surg, Eul-Ji Hospital during the period from January 1978 to December 1982 revealed following results.
1) 180 cases of biliary diseases were comprised of 162 cases (90%) of benign diseases and 18 cases (10%) of malignancy.
2) Male to female sex ratio was 11.22 in female predominance, and the peak age distribution was in the fifth and sixth decades as 95 cases(52.7%).
3) In the duration of illness, only 31 cases(17.3%) were within 1 month, and more than one third of the patients were operated after more than a year of illness.
4) The incidence of GB stones, CBD stones and both were 51.9%, 19.1%, and 21.4% respectively, and the incidence of intrahepatic bile duct stones was 16.0%.
5) The most prominent symptom was abdominal pain on RUQ area(76.7%), and weight loss was accompanied in most of the malignant diseases. The most prominent physical sign also was abdominal tenderness on RUQ area(82.2%).
6) The incidence of leukocytosis more than 10,000/㎣ was 42.6% in benign diseases. Urinalysis revealed bilirubin in 20.6%, and urobilinogen in 28.2%. LFT revealed increased bilirurin above 2.1 mg% in 32.0%, SGOT above 41 units in 39.5%, SGFT above 36 units in 38.4%, and alkaline phosphatase above 4.1 BU in 61.0%.
7) The stone shadow was shown in 8.9% of plain abdominal X-ray, nonvisualization of GB in 60.0% of oral cholecystogram, and non .visnalization of biliary tree in 45.7% of Ⅳ chola. ngiogram. The ultrasonogram was performed in 107 cases, and the accuracy rate was 74.8% (80 cases).
8) The post-operative T-tube cholangiogram, usually performed between 8 th and 11th post. op. day, disclosed normal findings in 77 cases(90. 6%), and residual stones in 7 cases(8.2%), etc.
9) The associated diseases were peptic ulcer(4.4%), liver abscess(3.9%), D.M. (2.8%), biliary cirrhosis (2.2%), and chronic hepatitis(2.2%), etc.
10) The 37cases of bile cultures resulted in positive growth except 9 cases of no growth, and the majority group was E. coli in IS cases(35.2%).
11) Cholecystectomy alone was performed in 57 cases(31.7%), and CBD was explored due to various reasons in 108 cases(60%).
12) The post-operative complications were wound infection (6.0%), residual stone (3.9%), wound disruption(2.7%), bile leakage(2.2%), pulmonary complication(1.7 %), and adhesive ileus(1.7%), etc.
|